Slide 1.Cloudy swelling, Kidney

A. Brief Descriptions

  1. Hydropic change or vacuolar degereration.

  2. Appears whenever cells are incapable of maintaining ionic and fluid homeostasis.

  3. The first manifestation of almost all forms of sell injury.

  4. Reversible injury.

B. Gross Findings

  1. Pallor, increased turgor, and increased in weight.

C. Micro Findings

1.    Cell swelling, cytoplasm contains coarse granules.

2.    Nucleus not affected in light microscopy..

3.    Pigmented cast, hyaline cast.

D. Others:

1.    The first manifestation of cell injury and is reversible.

2.    Increasing hydration of the cell due to alteration in ion transport at cell membrane.

3.    Cause: infection, physico-chemical injury ( toxic ), ischemia….

E. Reference

Robbins Pathologic Basis of Disease, 6th ed.  P.15.




Fig. 1-1 (LP)Cloudy swelling of renal tubules (left third) and normal tubules (right two third). 




Fig. 1-2 (LP)Cloudy swelling of the renal tubules. The outline of the tubular lumen is blurred.




Fig. 1-3 (HP)Cloudy swelling of the tubules (left two third) and normal tubules (right third).




Fig. 1-4 (HP)Pigmented (RBC) cast (red color) and hyaline cast (pink to purple color).




Fig. 1-10 (HP)The individual tubular lining cells are enlarged and filled with eosinophilic granules in cytoplasm. Note the normal nucleus.